Organization
I SMILE AT CROSSROADS DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARA JOHNSON (INSURANCE COORDINATOR)
(801) 561-1559
Entity
Organization
Contact information
Practice address
3409 W 12600 S, 100, RIVERTON, UT 84065-7260
(801) 561-1559
Mailing address
3409 W 12600 S, 100, RIVERTON, UT 84065-7260
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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